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Investigation of cardiac function in children with suspected obstructive sleep apnea
Adrian L James1, Martin Runciman, Martin J Burton
1Department of Otolaryngology, Hospital for Sick Children, Toronto, Ontario.
Insights
Cardiac failure is rare in children with obstructive sleep apnea (OSA). Preoperative electrocardiograms (ECGs) and chest radiographs (CXRs) are only needed for select patients with OSA symptoms.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Anesthesiology
Background:
- Obstructive sleep apnea (OSA) is increasingly diagnosed in children.
- Cardiac complications associated with pediatric OSA require further investigation.
- The utility of routine preoperative cardiac evaluations for pediatric OSA is not well-defined.
Purpose of the Study:
- To determine the prevalence of cardiac failure in children with suspected OSA.
- To evaluate the necessity of preoperative electrocardiograms (ECGs) and chest radiographs (CXRs) for these children.
Main Methods:
- Retrospective case record review of 271 children undergoing (adeno)tonsillectomy for OSA symptoms.
- Assessment of preoperative ECGs and CXRs for signs of cardiac hypertrophy or failure.
- Review of case records for evidence of cardiac failure during anesthesia.
Main Results:
- Only one child with pre-existing congenital heart disease exhibited preoperative cardiac failure.
- No instances of atrial or ventricular hypertrophy or failure were identified in the remaining cohort.
- No intraoperative cardiac events related to failure were reported.
Conclusions:
- Cardiac failure is infrequent in pediatric patients presenting with OSA symptoms.
- Routine preoperative ECGs and CXRs are not universally indicated for children with suspected OSA.
- Preoperative cardiac assessments should be reserved for select cases based on individual risk factors.
Objective:
To assess the prevalence of cardiac failure in a group of children with suspected obstructive sleep apnea (OSA) and to assess the need for preoperative electrocardiograms (ECGs) and chest radiographs (CXRs) in children with OSA.
Design:
Case record review of 271 children having (adeno)tonsillectomy for symptoms of OSA.
Method:
Preoperative ECGs and CXRs were assessed for signs of right atrial or ventricular hypertrophy or failure. Case records were assessed for evidence of cardiac failure during anaesthesia.
Results:
One child with congenital heart disease had signs of cardiac failure preoperatively. No other cases of atrial or ventricular hypertrophy or failure were found.
Conclusions:
Cardiac failure appears to be uncommon in children with symptoms of OSA. Preoperative ECG and CXR are essential in only selected cases.